Dayton Children's Hospital Director of Revenue Cycle - Revenue Integrity in Dayton, Ohio

Category:Facility:Dayton Children's - Tech TownDepartment:Partient Accounts - Billing AdministrationSchedule:Full timeHours:40Job Details:The Director of Revenue Integrity performs an integral leadership position within the Revenue Cycle operations of Dayton Children’s Hospital. This position supports the Executive Director, Revenue Cycle with the implementation of the Revenue Cycle strategy across many areas of the organization, and is responsible for the day to day operations within its overview. Specifically, the Director of Revenue Integrity is responsible for the leadership and management of several functions that are integral to the mid-cycle operations of the Revenue Cycle at Dayton Children’s. This position will oversee the functions of Medical Records, Hospital Coding, Clinical Documentation Improvement, CDM/Chargemaster development, and revenue integrity and reconciliation. Overall the focus will be to optimize the ability of our organization to accurately build charges, reconcile and maximize our charging efficiency and accuracy, develop KPI and quality/productivity standards for hospital coding and clinical documentation improvement, and optimize an evolving medical records department as well. This role will serve as a key partner for the Executive Director in developing and implementing strategic charging, pricing, and operational goals within this department designed to optimize revenue opportunities.

  1. Management of the Clinical Documentation Improvement Team Activities ( 30%)
  • Oversight and management of the CDI team and the Clinical Documentation Specialist Activities. Serve as the management leader for this team.

  • Work closely with CDI consulting support team to maximize opportunities and staff productivity.

  • Work closely with the hospital SLT to ensure the CDI program is meeting the needs of the organization and that it fits into the overall strategies in clinical management.

  • Manage the Clinical Documentation Specialists to ensure they have the support they need, are meeting productivity standards, and ensuring they are providing the quality of work as needed.

  • Become familiar with CDI goals and objectives both at DCH and within the overall industry, especially in Pediatrics.

  1. Lead the Hospital Coding and Medical Records functions ( 30%)
  • Work closely with the managers of the Medical Records and Hospital Coding functions to provide strategic and leadership guidance for their team needs.

  • For Hospital Coding – develop and maintain KPI standards to ensure we are balancing proper coding accuracy and production within this key area.

  • Identify areas of workflow improvement and develop these within the coding department or through collaboration with Epic/IT.

  • Understand and gain a working knowledge of the coding and reimbursement rules and methodologies that impact and are impacted by our work in the coding area.

  • Advise the Executive Director of tools, software, rules, and other options available to push this area into and maintain a “best practice” performance.

  • Work with our leaders across the organization related to process improvements in these areas.

  1. Revenue Capture and Integrity Leadership ( 20%)
  • Understand and oversee the DCH charging methodology and mechanisms. Work closely with the Executive Director, contracts, outside consultants, Pharmacy, and Supply Chain to ensure we have a strategic vision for competitive and optimal pricing structures.

  • Oversee the organizational CDM/Chargemaster build. Work to identify opportunities and implement projects and/or processes to revise the existing charge structures as necessary.

  • Work closely with the IT/EPIC areas to ensure that we are building our charges in a way that works best in our systems and operational processes.

  • Develop and oversee the CDM staffing to ensure we have the proper skillsets and productivity in these areas.

  • Work closely with coding leadership and leaders across the organization to ensure we are accurately capturing and reconciling our charge capture opportunities in the most efficient manner possible.

  • Identify any system based tools or resources that will make the CDM area effective.

  1. Organizational Leadership ( 10%)
  • Be the key leader across the organization related to opportunities to process improve the charging processes. Ensure we are working closely with operational and clinical leadership in all areas to make them aware of improvement options, and lead them through the execution of these goals.

  • Develop and maintain relationships with key leaders to support the CDI team as they continue to work toward quality documentation improvement, and make more in-roads with DCH physicians to get and keep buy-in on the program activities.

  • Develop and optimize relationships with the IT/EPIC teams to ensure we have proper prioritization of projects and maintenance workflows to ensure that the activities in these areas are up to date and getting the proper attention.

  1. Process Improvement and Staff Development ( 10%)
  • Work closely with the Executive Director and CFO to identify process improvement opportunities that may span beyond the specific set of controls of the Revenue Integrity area, but where that department is a key element of success.

  • Develop projects with the Value Improvement area at DCH to ensure improvements are achieved and positive ROI is obtained when warranted.

  • Identify staff development opportunities in all areas. Work with the Executive Director on staffing structure designs, opportunities and threat assessment, as well as succession planning at all manager levels.

_ Direct Reports

_ Indirect reports

At Dayton Children's we believe that each moment counts with our patients, families and with each other.

We are moving at a fast pace and are looking for the right talent for our team at Dayton Children's. We want people who embody our values and want to become a part of the Dayton Children's difference. If this is you, apply today!

Our values:

  • Safety--We make safety our first priority.

  • Compassion--We deliver compassionate, family-centered care to all we serve.

  • Ownership--We are the pediatric care experts and act knowing that every patient, visitor and the hospital is our collective responsibility.

  • Collaboration--We work collaboratively to care for children, their families and each other.

  • Innovation--We continuously innovate to make Dayton Children's even better today and into the future.

  • Value Creation--We deliver quality outcomes and excellent service while being good stewards of health care resources.